Hrt and emotional changes

[Erica Lauren James]

HRT and emotional changes
Last September I went to see a Dr about Hrt at a clinic and after my second appointment was prescribed my hormones.

After about a month i started to feel some tenderness in my breasts which is normal. Then after about 3 months i could see actual growth and when they would bounce they would hurt.

But shortly there afterwards I stopped taking them as I didn't find myself dressing at all. Is that a normal side effect that i just need to push through?

I must also say that I weighed about 175-180 Ibs then.

In the next few months I began to exercise and lost 20-25 Ibs and now find myself dressing everyday and quite feminine in boy mode. I now am back to wearing a bra daily with small inserts no matter how I am presenting.

So I'm guessing I'm asking if any other girls have experienced this and what was the outcome or how did you get past it and continue with your transition?

Thanks Erica

[Angela Campbell]

I really do not have the same ..."urge" to dress like I did before. I still wear womens clothes when I go out, but if hanging around the house it doesn't matter. I am just as committed as before on transition, but I have a long way to go and a long time to wait. I still work as a man until I get my facial hair taken care of, and when I am done for the day it is just too much work to get all dolled up. I do change into a nighty or something later in the evening though.

The HRT has not reduced my desire to go all the way, in fact I have more of a commitment and less fear of it now. There is no way in hell I would give up the estrogen. I feel so much better with it.

So I ask, did you lose the desire to transition to a womans body? The clothes really have little to do with it.

[TeresaL]

Thank you gals for having said this. For six months, it bothered me so much when dressing lost its luster that I went into a mourning stage because of the perceived loss. I really have had to evaluate where gender issues fit into my life. I've since realized that my transgender direction is much deeper than clothing. It is internal, kind of like the seat of my affections. That core female in me is there no matter what I wear.

Being retired, I can get up in the morning, go into my workshop and turn pens on my wood lathe. One GG was terribly injured turning a bowl which broke apart and flew into her face. So I don a full cartridge respirator and a face shield. I don't wear a wig and makeup during those times. However...

When I go out I may be fully attired in women's garments, and it feel like home. I love being treated like a women, including being called ma'am and ms.

HT took my dysphoria and calmed my transitioning down a notch. I can live in the space HT has given me. Nonetheless, if doors open, I would accept GRS and live permanently as a woman.

[Ann Thomas]

I've been wondering if the same could happen to me, Erica. I've had quite a struggle with lots of issues regarding all this. I have an SO that is very much wanting me not to go through transition without thoroughly exploring all possibilities, including medical and psychological. At the end of last year, in an agreement with my SO, to try to figure out why I was having many physical problems, I went to see a nutritionist and got a new Primary Care Physician, and saw him as well that week. They found my Testosterone was low and gave me a topical gel to use. The T actually made me want to present as female far more than before, which surprised me.

Now, months later, after dealing with other issues, I just saw an endocrinologist for the first time to begin exploring transitioning using hormones. He's had me stop now from taking any more of anything that would affect them. Then, he's going to have me tested after 3 weeks, then I see him again in 4 weeks after the results are back, and we can begin discussing what will work for me. I'm really wondering if my desire to present as female will be as strong. But, I've been wrestling with this for so many years - decades - now that I know better than to stop. But, I am interested in the effects stopping the T gel will do to me.

Ann

[Marleena]

From Ann Vitale (gender therapist) I left out the part about rejection, this is what is common.

CATEGORY 6: HORMONES
1. I have heard that one of the uses of hormone replacement therapy is to see if the individual accepts or rejects the treatment. In your experience (or in other documented sources) where there was a rejection, what are the responses?

First of all, keep in mind that a referral for hormone replacement therapy is made with great caution. Individuals are not only evaluated for severity of gender variance but they are educated to the effect the hormones will have on them. Most of the people I see come in very aware of the effect HRT will have on their secondary sex characteristics but few are aware of the general health risks and the psychological effects they will experience. For example, I explain to all my clients MTF clients that paradoxically taking estrogen will diminish not only their libido, it will diminish their need to crossdress. I know that is counterintuitive but it is a fact.

[Rachel Smith]

:2c: I have been on HRT and an AA for about 3 months and though I still perfer to wear womens clothes everywhere but I don't present as female at work. I just don't consider it crossdressing now but rather just dressing. Does that make anysense?

[Angela Campbell]

Exactly what I have noticed. It has diminished the desire to crossdress, but it increased the desire to complete transition. It seems like the more I do and the closer I get the more I want it.

Actually when I dress as a man I feel like I am crossdressing, or wearing a disguise. It doesn't bother me too much but I think it is an ugly appearance.

[TeresaL]

Adding to marleena and AAL posts.

Vitale's note #15 points out that to a subset of us testosterone is a toxin.
High T = more dressing.
Less T = less dressing. As if we were cured. But beware the cycle. We need the hormones to stop excess dressing, but where do we go from there? She doesn't get specific after that. Choices? Do we have choice? My take is we have a direction or two.

We can go back to living as women. Or. We can remain in our birth gender using HT to maintain it.

While HT changes our bodies, it doesn't move us to dressing. It can stop our dressing. If your dysphoria is excessive, you will probably push on. Just my opinion, YMMD. It's a crapshoot. It would be nice to see actual facts and statistics.

And rachel, same here. It's dressing to the inward gender, which is female. It's not for the thrill, but to be ourselves.

[Marleena]

@ Erica. I'm confused as to why you would stop the meds? It's normal to feel cured but stopping will bring the GD back. I ran low on money and tried to stretch my meds out and I felt like I was going nuts again.

[LeaP]

... It has diminished the desire to crossdress, but it increased the desire to complete transition. It seems like the more I do and the closer I get the more I want it.

Actually when I dress as a man I feel like I am crossdressing,

Your experience mirrors mine exactly. I seldom dress, as much because what I have doesn't look good or doesn't fit any longer as anything else, and when I do it just feels like normal clothing. I'm back to wearing women's jeans most the time but because they fit better. I seldom wear my tops because they are mostly in styles that never really looked right on me anyway. I just never knew any better. On the other hand, I've been thinking of wearing more jewelry lately and getting my ears pierced. Odd, because there's no sense of "dressing" with those thoughts.

I also echo the comment on wanting to complete transition. My vision has shifted forward.

Finally, your comment on the sense of cross-dressing when dressed in male clothing brought me instantly to the scene where I first experienced just that. I was wearing an expensive suit and the sensation of being in costume came on me so strongly that I actually started laughing as I was walking through the building.

[ReineD]

Marleena, I've just googled Anne Vitale. She is not an expert in the field other than having a degree in psychology, having a practice to help TGs, and having transitioned herself. She is not a medical doctor, has not published any research or at least I cannot find her cv or a list of published papers on her website. She did write a book, but it is about her own personal experiences. So it looks to me as if she might have a bit of tunnel vision, although her motives are good and she does want to help.

You've posted before Vitale's bit about a lessening of libido causing an abatement of crossdressing desires. It seemed odd to me that individuals who experience this will ignore it, since HRT is often used as a diagnostic tool, specifically to see if the lessening of libido will cause a decrease in the desire to present in the target gender. This is supposed to indicate the patient might not be TS.

It disturbs me to see that Vitale implies otherwise?

Am I missing something?

The biggest danger IMO, is to encourage people who question themselves especially after experiencing decreased desires, to not listen to their instincts and to proceed with transition anyway. Admittedly I have not read all of Vitale's essays and maybe the bit you quoted is out of context. But still, I think that caution is warranted.

[Barbara Ella]

This is my experience precisely. My dysphoria was severe when starting HRT. Vitale focuses on the T levels as the driving influence, I feel it is the proper combination of low T and high E. I attribute my mind and body chemistry being more in line which provides the desired result of a peaceful (somewhat) existence. Before HRT, it was the dressing that attempted to provide the satisfaction of mind and body appearing to be in sync...they really were not, and there was no peace, just an increased need to keep trying. On HRT, they are more in concert, and the overwhelming driving need to dress just isn't there. I still present female, and am doing more and more, but do not feel the driven urge to do so, and will seldom do complete dressing (makeup forms, etc), it just seems to be more a more natural act of just putting on my clothes.

Barbara

[sandra-leigh]

Reine, in my reading there are three possible outcomes from MTF HRT. (1) A sense of relief, and generally feeling good and gender confirmed. This happens mostly with Benjamin type 5 transsexuals (type 6 transsexuals probably already have their brain running on estrogen so they are more likely just to get psychological relief); (2) A sense of depression, wrongness, feeling ill. This happens mostly for cis-males and usually indicates the person should not take or will not benefit from HRT; (3) least common, not really feeling particularly good or bad but the feelings of gender compulsion and dysphoria reduce notably. This happens mostly with type 4 transsexuals / transgender. When it does happen, such people are said to be the ones who most need to take HRT for the long long term -- as it likely implies that the person's brain has physical internal gender conflicts that the HRT rebalances, so the person will probably only be at peace while on HRT. The type 5 and 6 transsexuals needing the HRT for body changes, the type 4 transsexuals needing continued HRT for brain relief.

I fell into that third category, needing the brain relief.

[Angela Campbell]

You've posted before Vitale's bit about a lessening of libido causing an abatement of crossdressing desires. It seemed odd to me that individuals who experience this will ignore it, since HRT is often used as a diagnostic tool, specifically to see if the lessening of libido will cause a decrease in the desire to present in the target gender. This is supposed to indicate the patient might not be TS.

It disturbs me to see that Vitale implies otherwise?

Am I missing something?
.

According to my therapist it is not used as a diagnostic tool. However it is common that some who have severe dysphoria can be happy not transitioning. The treatment is meant to stop when relief is achieved. If HRT is enough then the medicine is continued and the dysphoria is lessened and life goes on. Some need more and they transition and go full time, others still go further and seek SRS. However the therapist will usually determine whether a person meets the need for the hormone treatment before the letter is given.

Lessening of libido began for me a long long time before I ever took any hormones.

[ReineD]

Thank you Ellen (and everyone else). I agree that lessening of libido can happen for a number of reasons. But if someone is not TS and who wants hormones for reasons other than GD, should convince herself and a doctor/therapist that she wants to start hormones, then hopefully the drop in libido will be enough to indicate to her/him that further hormones might not be a good idea? So might it not be wise to exercise some caution and not continue to imply that everyone who starts hormones may be TS (if they are not) by telling them it is normal for TSs to experience a decrease in libido even if the latter is true?

Pardon the stupid analogy, but it's like a dog who has green spots asking someone, "Am I a chicken", and receiving the response, "Yes, chickens have green spots".

I remember being shocked when I first heard HRT being used as a diagnostic tool. It didn't seem right, to mess with hormones just to see if someone is TS or not. I asked the question here hoping that I had been misinformed but some of the TSs confirmed that some doctors do use HRT in that manner. I often wonder how consistent is the treatment for GD (CDs and TSs) in the US, from state to state, doctor to doctor, despite having the WPATH guidelines.

[arbon]

I often wonder how consistent is the treatment for GD (CDs and TSs) in the US, from state to state, doctor to doctor, despite having the WPATH guidelines.

I think there is very little consistency its evident from hearing the different experiences from those transitioning but also the differences from the guidelines from different doctors / clinics out there.

[Angela Campbell]

Yes it is pretty obvious that there are quite different approaches to treatment from area to area in many ways. I have seen it here from many different people. Dosages, the letter, all vary quite a lot even in the same town. And yes it seems scary to use something as powerful as hormones as a diagnostic tool, but I am not a DR. so who am I to say?

The drop in libido is not only common it is pretty much expected when antiandrogens cause a lowering of the effects of testosterone, but I would expect a true transsexual would still have the need for going further. I have been told there are some who continue HRT and do not transition but I have never met one. Then again there are so many ways this can effect someone that nothing really surprises me anymore.

It would be my advice not to even start hormones unless you are convinced you need to. Not 95% sure but 100%. All the TS women I know in real life always knew they were. But then I only know 10 or 12.

And Arbon......your avatar......just...damn! cool.

[stefan37]

Hrt for me was a life saver. My anxiety went from a+10-0 in 3 days. That confirmed for me estrogen was the hormone missing in my life. Libido has diminished, but that from what I am told is from AA's. I have reports after SRS an ddiscontinuos of AA's libido returning. I also lost that pressing urge to dress. But there is no way would give estrogen.

[Marleena]

You've posted before Vitale's bit about a lessening of libido causing an abatement of crossdressing desires. It seemed odd to me that individuals who experience this will ignore it, since HRT is often used as a diagnostic tool, specifically to see if the lessening of libido will cause a decrease in the desire to present in the target gender. This is supposed to indicate the patient might not be TS.

It disturbs me to see that Vitale implies otherwise?

Am I missing something?



@Reine Anne has treated a lot of TS people, she is a gatekeeper.

What I posted was her findings based on people she found ready for HRT (diagnosed).

Think of it this way.. many TS do CD for some relief. She is simply stating that need will go away and their will be a libido drop due to the lessening of T levels. This will not bother a TS person. It's also stated that a TS person will find relief from HRT and sense of well being. She went on further to say those she gave HRT to were responding positively.

However a CDer will instead be anxious on HRT because of the drop in libido, etc, because it is not a cure for Cding otherwise it would be used for that purpose. A CDer is male and removing "T" from the equation and replacing with "E" would cause anxiety and discomfort.


Here is the question and full reply. It's not about HRT as a diagnostic...just her findings.

CATEGORY 6: HORMONES
1. I have heard that one of the uses of hormone replacement therapy is to see if the individual accepts or rejects the treatment. In your experience (or in other documented sources) where there was a rejection, what are the responses?

First of all, keep in mind that a referral for hormone replacement therapy is made with great caution. Individuals are not only evaluated for severity of gender variance but they are educated to the effect the hormones will have on them. Most of the people I see come in very aware of the effect HRT will have on their secondary sex characteristics but few are aware of the general health risks and the psychological effects they will experience. For example, I explain to all my clients MTF clients that paradoxically taking estrogen will diminish not only their libido, it will diminish their need to crossdress. I know that is counterintuitive but it is a fact.
I also warn them that getting on estrogen can result in a sense of well being that leads to a strong desire to continue taking it. They had better be prepared for that consequence. A similar feeling of well being is reported by FTMs on testosterone.

I am not aware of any documented study of people rejecting HRT but an informal review of four of my colleagues show that out of the 1500 plus people we have collectively seen over the last 20 plus years, there have only been a handful of people who have stopped HRT once they have started. Two of us had patients who stopped because they complained that it reduced their libido and it decreased their desire to crossdress. Two of us report where a client has been frightened off after their breasts began to develop. One of my clients eventually had an orchidectomy and had his small breast development removed surgically and continues to live in the male gender role. One of my colleagues reports a similar experience with his client also having a double mastectomy.

[emma5410]

I am in the UK and saw a psychiatrist who specialises in gender issues privately. He told me that HRT is of no use as a diagnostic tool but that there was evidence that it acted as a mild anti-depressive. That may have a lot to do with the hoops you have to jump through in the UK before HRT is prescribed. Admitting it was useful for diagnosis does not tally with the normal procedure of forcing people to go full time before prescribing.
I felt much better when I started HRT. I just felt right but it did not remove my dysphoria. In fact it got steadily worse until I had to go full time. As for dressing I was already dressing whenever I was alone which was a lot of the time as I live alone. Dressing as a woman just felt natural. HRT had no effect on that. It did reduce my libido but it has not gone completely.

[LeaP]

According to my therapist, the lessening of drive to dress is virtually universal. She will not write the letter to diagnose per se, but does look for whether or not female identity persists, and whether the drive to transition changes. My urgency to dress disappeared almost instantly, replaced by a simpler desire to look nice, if that makes sense. (It probably doesn't as I look like crap, not knowing how to dress well, but I digress.) I can best express the difference as dressing as an event versus just getting dressed. I can now toss something on without thinking much about it.

Many of the symptoms I had categorized as dysphoria lessened or disappeared (notably social anxiety and dissociation), replaced by a sharp focus on congruence. The inner monologue returned rapidly after briefly disappearing and the desire to transition became more of a sharp pull, even a painful longing.

Libido drops after HT start for most, but not all. It totally tanked for me and was an enormous relief. T is like meth to a MtF ... but without any attendant pleasure. It was the first time in decades that I felt like I didn't have a whip to my back every second. I have always felt psychological pressure and anxiety (bordering on panic at times) from T, but did not expect to experience the loss of libido itself so positively.

Libido starts coming back for most after a while. That started for me a couple of months ago. Milder. Different. I don't quite understand it yet, other than it isn't pressured.

[Lorileah]

Confused. Isn't the idea to be more like a GG? Do you think they sit around all day thinking, "geez I wish I was in panties and a dress"? Maybe I look at this from a different angle but look around. Women don't usually "dress" (and I assume when one says dress they mean overly feminine..the clothes that scream female) but dress to be comfortable. Does the OP mean that while on hormones they looked in the closet and said "No women's slacks today, I want the men's chinos"? (which of course would be OK too as many women find them more comfortable). It seems to me that if the clothes are the most important part of your transitioning, then maybe you should not transition :idontknow: I also don't think using the HRT as a therapeutic trial is a wise idea. Isn't the plan of HRT to put you in a more female frame of mind? I love clothes, but I also know that as time goes by I will probably go into a mode where less dressy will replace what I do now. I will continue to wear clothes that are professional for whatever occupation I am in but I doubt that a dress daily will be the standard.

At the risk of being tagged as "trannyer than thou" I suspect that the OP wasn't ready for the HRT yet (we have discussed common side effects in these boards for so long that I kind of thought EVERYONE knew sensitive breasts were common). To quit when things started to go in a direction they didn't want (or expect which I put fully on the therapist for not trying to explain that) seems that maybe they would be happier staying where they are and not pursuing HRT. Maybe back off and get more counseling? I just think if the clothes were the main impetus and the standard of why they went on HRT, then it wasn't time.

[LeaP]

I'm inclined to agree, Lorileah.

Erica, stopping hormones to re-invoke the desire to dress is pretty telling. Having stopped and then asking about "pushing through" transition is unusual at the very least. I started hormones knowing that transition was a likelihood, but not a certainty. I wanted to see if hormones were enough. I was also fully prepared for permanent changes either way. As it happens, it was not enough. I did lose the dressing urgency, but though interesting, it was completely irrelevant to the need to transition. I.e., there is nothing to "push through" in that regard.

A better way to view how (good) therapists regard hormonal impact is confirmation, rather than diagnosis. As your need to dress and feel feminine as a result appears to be paramount, hormones (and transition) may not be a good path. Perhaps you are more an intense crossdresser with a level of gender-variance?

[emma5410]

Ah. So there is 'dressing' and dressing. I dressed in normal clothes i.e. no frills etc. I found it only natural to dress as a woman. Dressing as a man increased the incongruence and the GD.

[Erica Lauren James]

Thanks for the replies and dialog ladies, I have learned a few things.

Now to cover a few questions

I guess there were a few reasons for stopping(postponing) HRT

1. My Dr. only has appointments on Tuesdays and with work related things I could no longer make any appointments and I didn't think continuing without blood work and Dr visits was a good idea.

2. I wanted to lose some weight and was told that its very very hard to lose while on HRT

3. the urge/need to become a woman subsided

My dysphoria isnt excessive at all and has never been, unless every waking moment when I don't have to present as male I spend female and even when presenting as a male i would wear my bra with small inserts, always ladies jeans/pants (male presenting but rather feminine looking)

Hrt changed that

Sandra-Leigh I'd be in the third category as well I don't hate my life as a male but I know I would love it even more as a female. I guess the other part of it is my kids. They are just about 18 and 16 and don't really want me to transition, at least not for another 10-15 yrs and I don't want to hurt them.

And then I have crazy thoughts like this. My kids could very well make it to an Olympics 4-8 yrs and as the camera(the world) scans by and the commentators say " and there are her parents" and there are two women sitting there if her mom can make it. Sounds crazy I guess the uncertainty of those auckward moments make me nervous

Lorileah And yes I knew of the breast changes and that they'd become tender and sore But the one thing I don't know is what the heck does "OP" stand for

Erica

[MatildaJ.]

OP stands for "Original Poster" or sometimes the "Original Post." It usually means someone is trying to bring the topic back to the point of the thread.

[JohnH]

I don't have a lot to say but for me M2F HRT is a godsend. I am no longer depressed the way I was. I also have a much longer attention span. Also I don't have the urge anymore to wear dresses outside the home nor to wear skirts outside so often. My wife has noticed such an improvement in my attitude so that when I get angry or frustrated, she says to me, "John, did you miss your hormone shot?" :)

I really like the effects on my body - if I get get by the razzing of my wife calling me "titty boy" or "bra man". :) It does not bother me that my wife refers to me with masculine references, and it's not important to me that I pass as a natal or genetic woman. However, she has told me a number of times that "You are not a man". :heehee:

Johanna

[ReineD]

According to my therapist, the lessening of drive to dress is virtually universal. She will not write the letter to diagnose per se, but does look for whether or not female identity persists, and whether the drive to transition changes.

Yes, that's what I was trying to get at, thank you.

Obviously if the drive to transition persists, then the person should carry on. But sometimes we'll have people share that everything decreases ... libido and drive to present in the target gender, in fact any drive to be other than birth gender and the person begins to question themselves. It is in these circumstances I am suggesting that we (the collective we), not dismiss the possibility that perhaps this person was not meant to transition rather than say, "Oh yes, this happens to us all the time" implying that someone who is potentially not TS might still be TS.

I think that in circumstances like these it is best to keep in mind that not everyone who starts hormones is TS, and rather suggest a discussion of their feelings with their doctor and do what I like to suggest all the time, which is to just go with the flow (meaning to not force anything) and just see where it all leads. Eventually, things do become clear even if the answers aren't there immediately.

[charla42]

For me HRT was a Life Saver!!!!!. I have never had the desire to Transition because of My Family. However, my desire to crossdress was out of control. My Libido and gone south a long time before I started HRT. After two years on HRT I feel that my brain has been re-wired. My desires to dress have nearly disappeared. The physical changes are very apparent. Now days I mostly underdress. The good thing is my mental distress is gone. Have a great day. Charla

[bas1985]

My Gender Terapist in Italy said that there are also rather different types of HRTs. Different in quantity, in dosage, so to speak. She said to me that some people are happy with a very mild dose of HRT, I suppose that she referred to type 4 TS, those who only seek some sort of brain relief, like a "mild antidepressant". Other, those who really want to change the body, go full throttle (if health is OK) and are happy with the side effects (also not wanting to cross dress or diminishing libido).

So I think that we may talk of different types of HRT and maybe also different responses. Maybe an already feminine body responds to a mild dose of estrogen quite impressively, whether a full "masculine" body requires a different amount (and/or time) of feminine hormones. And the effect on the brain are different.

I am not on HRT (yet, I have to wait the six months of therapy), but I think that I am more of type 5-6, because my brain is already "happy" in its gender (female), I just want to make the body congruent (or try to make it), that would be the only reason why I may start HRT. But I speak for myself...

[ReineD]

Thank you, bas1985 and also Sandra-Leigh earlier, for bringing up the various levels of trans. I think this is important to keep in mind and also, we never know what dose an OP is on when they describe their reactions which does affect their reactions to HRT. As you say, if a mild dose of HRT is enough to bring peace to a Type IV without having to change their lives and live full time or transition, then it is not advisable to give the impression they should go further because the lull in desires happens to every TS even the Types V & VI.

[LeaP]

I agree, Reine. My initial response was narrowly focused on the (losing the desire for) dressing aspect, which is very common. I believe it reinforces the truism that it isn't about the clothes.

[dreamer_2.0]

Interesting discussion. Where could I find information on the types of TS? Did I miss it in this thread?

[ReineD]

Dreamer_girl, as an aside to this discussion, it is Dr. Benjamin's Gender Scale that he developed in the 1960s. There might be some debate about sexual orientation of all the different types, and there is also overlap between the different types (nothing is cut and dry), but the point is that gender for transpersons is a continuum and not an on and off switch that indicates someone is either a crossdresser or transsexual. There are degrees:

http://harrychart.goiar.f-m.fm/Original/OriginalChart.jpg

[deborahtg42]

Fantastic thread, very interesting

[Kathryn Martin]

.... because the lull in desires happens to every TS even the Types V & VI.

Unless of course you never dressed prior to transition......:p

[ReineD]

LOL Kathryn ... exactly.

We need to come up with a way to consider everyone's possible circumstances when responding to these threads. :p

[Rianna Humble]

I am curious. Who are all these TS members who (contrary to the vast majority of TS members on this subforum) keep pushing people to transition at all costs?

The OP makes it clear that she is asking whether other people had a similar experience towards the start of their HRT and how they got over it. This does not immediately suggest to me that the OP does not identify as TS and in fact there is a fair body of evidence that this is exactly how she identifies.

In the context of the original question, it is perfectly acceptable for other TS members to post about how common the experience described in the OP is amongst the TS population and to assume that a member who self-identifies as TS might actually self-identify as TS.

[LeaP]

With all due respect, Reine, Benjamin's scale was not intended to describe a gender continuum. It is a loose categorization of two primary attributes found among both transsexuals and gender variant people, namely sexuality and intensity as it relates to congruence and the need to transition. The purpose was to assist in decision treatment of transsexuals. It continues to provide a relevant reference for discussion, particularly from the intensity standpoint, though the scale is now regarded as obsolete.

A transsexual is a transsexual. A so-called type 4 has a different level of urgency to transition, but may be 100% as firmly gendered as the type 6.

[sandra-leigh]

Suppose you are on a medication. After a time, you start to feel "all right", and that things are okay. And perhaps there are unpleasant side effects, or perhaps continuing is costly or inconvenient (even if only for having to disrupt your schedule to visit the doctor from time to time.) And perhaps further the condition for which you were taking the medication has some social stigma, some of which you might have internalized.

So, given those factors, do you need to continue the medication? or can you stop it because you do not need it anymore? What a relief if you have got your life back together, that you are no longer depressed / schizoid / paranoid / transsexual / whatever ! Maybe you never really were that thing, and just needed time to heal or get your life or thoughts together ?

Answer: we don't know. Apparently 90% of people get better by themselves (as a general statement, not for any one ailment.) Perhaps you were "just going through a bad period". But!

There are some illnesses which have a fairly high relapse rate, because the patient tends to think that they do not need the medication anymore and stops taking it, but it was the medication that was sustaining them and they get worse again without it. They might not notice for rather some time, and when they do notice they might think that it is a new occurrence rather than the old one continued.

I myself, during the decade of my depression, have several times been left wondering whether the medication is still doing me any good, and have stopped taking it to find out; more than once I have found that the medication I was taking is no longer benefiting me, that I have settled into a level that the particular medication cannot shake me out of. Even when a medication was sustaining me to some degree, it can take a fair number of months without for me to deteriorate to the point of needing to re-boost (e.g., 8 months last time I did such a test.) My personal experiences have proven to my satisfaction that for my depression I have a long-standing biological imbalance, and that with medication for me it can be like filling up a reservoir that has a small leak, taking a long time before the imbalance starts to have a strong effect. It is the persistence of the pattern that allows me to conclude this, but certainly on the first cycle it would not have been possible for me to determine that it was not the case that I was "better". After all, quite a few people really do get "cured" of depression in the sense of not requiring long term care for it.

When I went on HRT and my gender dysphoria became so much less, I did (sometimes still do) question whether I am "really" transgender / transsexual. I have to rely on my experience with depression to recognize the potential pattern of "my dysphoria is only being relieved because I am on medication that is controlling it." My searches find clinicians warning of exactly this possibility, that it is the people whose dysphoria fades on HRT but who do not "feel bad" who are most likely to be the ones whose dysphoria is rooted in biological imbalances that will need permanent controls.

How to tell the difference between such people and people who should not be on HRT? It is not always clear. But if their mental relief over the incessant internal conflicts exceeds their dislike of loss of libido and loss of excitement in "dressing up", then they are more likely internally dysphoric. The person who says "I don't care whether I end up male or female, but I need this conflict to stop!" may be in this category.

Is it normal for such people to question what they "really" are? Yes, pretty normal. Transitioning is hard work, with numerous disadvantages. Giving up the life one had, the relationships one has, even the loving sexual intercourse, is a hard thing to go through. As people here have often said, "Don't transition if you don't need to"; people in this dysphoria category can certainly end up needing to continue the HRT in order to stay semi-sane, but with their form of dysphoria no longer slamming them around, finding that they can get along without formally transitioning. They might not be exactly happy to continue on as male, but they might be "content enough" on balance.

I have sometimes described what happened to me on HRT in this way: Before, I was like a package of Jiffy-Pop Popcorn (http://www.youtube.com/watch?v=-J1DpXWxrHA), the internal pressure of my dysphoria yanking me around this way and that, exploding within me, distorting me, pushing my boundaries larger and larger, and I was helpless in the matter. But on HRT, it was like the stove had been turned way way down: it wasn't that the dysphoria wasn't still there, but it calmed down, no longer driving me irrational.

Did I dress less? Well I moved to more sedate clothes, and for a number of months even just went to my social club however I happened to be dressed. I stopped shopping for clothes for months at a time because I already had enough. But at the same time, when I did wear a skirt or dress out, it stopped being about the "dressing" and started being because those were the right clothes for me to wear. The dressing was no longer "exciting" or "daring" or as a result of my insides being pushed nearly inside-out" it became normalized as a proper part of my life. I became less in thrall, and instead quietly, without rushing, became more female.

[Kathryn Martin]

LOL Kathryn ... exactly.

We need to come up with a way to consider everyone's possible circumstances when responding to these threads. :p

If we recognize that individual circumstances vary with every person and at the same time recognize that there are common underlying conditions from on which the individual circumstances arise then we might actually get somewhere with the analysis of transsexualism.

Rianna, what is addressed in this thread does not necessarily make any statement about whether someone is TS or GV or whatever. The issue is whether hormone intake reduces the urge or need to dress cross-gender. I think to use the reduction of an urge to dress through hormone intake to "diagnose" transsexualism or gender variance is nothing short of psychological professional insanity. Cross-sex identification is something quite different than cross-gender identification.

Lea it is not about sexuality but cross-sex identification. In this sense I am of the view that I type 4 would have a high cross-gender identification and a low cross-sex identification. Type 5 or 6 actually have a very firm and not changing gender identification which cannot be said about a type 4.

[Rianna Humble]

Kathryn, I was not questioning what the thread was about but one member's constant reiteration that there are hordes of TS ready to push people to transition at all costs. I see no evidence of that either in this thread - which is about what TS members might experience through the use of Hormone Therapy - or in this sub-forum.

In fact, I would go so far as to say that the interjection of the allegation that we are wantonly ignoring the possibility that someone might not need to transition could risk derailing a straightforward question from someone who is asking about how prevalent the loss of desire to dress is amongst TS members at the start of Hormone Therapy.

[ReineD]

Kathryn, I was not questioning what the thread was about but one member's constant reiteration that there are hordes of TS ready to push people to transition at all costs. I see no evidence of that either in this thread - which is about what TS members might experience through the use of Hormone Therapy - or in this sub-forum.

Rianna, if this refers to me, I'm sorry if I gave that impression. I think that both things happen simultaneously: incompletely formed statements that can appear as if it is taken for granted that someone who questions whether they are TS or not are on the same path as every other TS here, and TS members who do always keep in mind that every situation is different. I by no means wish to imply there are any attempts to intentionally derail the OP.

[TeresaL]

I've seen this chart dozens of times, and can find myself in every way, shape and form under the label "type 4." I don't have much overlap either direction either. Could you not present the chart to a therapist or doctor who has never seen it and point to aspects that fit your life so that they could make a decision on whether to allow you to take hormones or not?

My doctor pulled estrogen from my regimen based on my dressing habits which changed via HT from "every time I got the chance" to sometimes alternating (per group 2, type IV).

Looks to me like the chart, although old and possibly obsolete, could be utilized to help our PCP or endo sort things out. Or as an aid for the OP.

However...
Gender Dysphoria is becoming an important issue in determining a justification for HT.

[LeaP]

Kathryn, I disagree. The primary attributes in the scale are sexuality - "Sex Object Choice and Sex Life" - specifically how homosexuality from the perspective of assigned sex is manifest, and transition urgency - most clearly seen in the "Conversion Operation" descriptions. Benjamin (incorrectly, but understandably, given the thinking of that era) directly correlated sexual preference and transition urgency into a unified concept of psychosexual inversion. The resulting categories are variations of "Gender Feeling."

People often read this as a gender continuum. If you read Benjamin's descriptions carefully, however, you will see that the variations are not gender feeling per se (despite the description), but the ability to relieve dysphoria based on transition need. You may INFER a continuum, but Benjamin's scale wasn't meant to convey that. In fact, the table contains strong elements of the binary! Types 1, 2 and 3 are labeled "masculine." Types 5 and 6 are unambiguously labeled "feminine." Only type 4 is listed as "wavering." Given that, a better reading of the chart is that the first three and the last two are completely in the binary and only one type is gender variant.

In the end, the obsolete elements of the classification leave us where we were. That is, we accept (most of us, anyway) that transsexuals vary in their level of transition urgency. Second, many of us believe – as I do – that one element of "true" transsexuality is female identity. That, of course, is also reflected in Benjamin's chart ... where no distinction is made between the "feminine gender feeling" of types 5 and 6, and both of which are labeled "true" transsexuals. And finally, since we accept that sexual preference and gender are ultimately divisible, Benjamin's unified psychosexual inversion concept falls apart.

That is not to say that psychosexual inversion is invalid! I believe it well-describes some individuals, just as autogynephilia describes a few individuals. But as a broad characterization of the transsexual population it does not work.

My reading of the scale can be reduced to this: if you have a female gender identity and are driven to transition, you are transsexual. If you're not so sure or if you don't need to transition at any level, you're gender variant. Everyone else is a transvestite. Benjamin doesn't even address FTM's. In the chart's terms there are three categories of men, two of women, and one for people stuck in the middle.

[TeresaL]

Type 4

Trying to make some sense of it all,
But I can see that it makes no sense at all,
Is it cool to go to sleep on the floor,
'Cause I don't think that I can take anymore
Clowns to the left of me, Jokers to the right,
Here I am, stuck in the middle with you.

Yes I'm stuck in the middle with you,
Stuck in the middle with you.
-------
After that little ditty, I must say that gender variant is the most lonely place in the world of transgenderism. CDs can look to us as TS, and true TS can look to us as CDs or gender variants. We get no respect. (EDIT: From "I aint got no respect"; Rodney Dangerfield) We are neither hot nor cold, but Luke warm and prone to get spewed out if we care to get too near. We can have gender dysphoria, yet we may be turned down for hormones because we may revert to our at birth physical presentation, simply because our wives want their husbands visible for a couple hours. Yet our own hearts tug at us and are wont to bring us back into our preferred gender, our internal female, because our core being is female. That is short lived too because familial circumstances tear us apart again to join them as "papaw," or "dad." Yet we oblige, and are happy when our mates allow us female privileges or buy us feminine gifts. We love our smooth bodies and small breasts, and ignore those who berate us and question how we are going to hide our female development. We are not she males though. We are cyclical. We are stuck in the middle.

[Angela Campbell]

Thanks for the replies and dialog ladies, I have learned a few things.

Now to cover a few questions

I guess there were a few reasons for stopping(postponing) HRT

1. My Dr. only has appointments on Tuesdays and with work related things I could no longer make any appointments and I didn't think continuing without blood work and Dr visits was a good idea.

2. I wanted to lose some weight and was told that its very very hard to lose while on HRT

3. the urge/need to become a woman subsided

My dysphoria isnt excessive at all and has never been, unless every waking moment when I don't have to present as male I spend female and even when presenting as a male i would wear my bra with small inserts, always ladies jeans/pants (male presenting but rather feminine looking)

Hrt changed that

Sandra-Leigh I'd be in the third category as well I don't hate my life as a male but I know I would love it even more as a female. I guess the other part of it is my kids. They are just about 18 and 16 and don't really want me to transition, at least not for another 10-15 yrs and I don't want to hurt them.

And then I have crazy thoughts like this. My kids could very well make it to an Olympics 4-8 yrs and as the camera(the world) scans by and the commentators say " and there are her parents" and there are two women sitting there if her mom can make it. Sounds crazy I guess the uncertainty of those auckward moments make me nervous


Erica

From this It looks to me like you may not be ready to transition. You still have fears and are making excuses on why you shouldn't. Transition is a pretty serious thing and if not completely sure it is smart to take a step back and think it over. You have valid concerns and it is a good idea to settle these before taking the big step.

I knew I was going to transition no matter the costs when I made my first visit to the therapist. The first words I said to him were "I want to transition" We went through the hoops and looked at my life and reasons and I started HRT a couple of months ago. My need to transition is actually greater now and I am more sure of this than ever. My therapist was very interested in how I felt about this after beginning HRT and once he was pleased with the results he agreed I was making the right choice.

My dysphoria did not go away. It is still here but is kind of being nice as long as I am making progress. I do not dress nearly as much as I did before I started HRT but when I do it is more of a casual style for sure. (unless I am going out to a really nice place) I still need to present as a man at work for a while but have started making plans for that and going full time.

According to the Benjamin scale I would be a type V leaning towards a VI

[stefan37]

While living in the middle can offer relief, it is a difficult place to be. I know several that live in the middle and they are making it work. 1 is on hormones and floats between the 2 genders, the other 2 are not, 1 tends to live more female, and the other tends to lean more towards male. One thing about all 3 is they own who they are. they have accepted themselves and make no excuses or justifications. They have for the time being found balance and no matter where on the scale you may find yourself, the key is to find your balance. Where is it you find relief and comfort? I do not think finding balance is wanting more yet not going for it because of other pressures, but truly finding your balance. Only at that point can you feel content.

HRT can provide relief to many and if it does and your care giver refuses such treatment, seek out another. even if it is out of pocket. People have no problem shelling out thousands for car repair, vacations etc, but refuse to put one dime into their health care. I pay for my endocrinologist visits out of pocket. the initial assessment cost 395 and each quarterly visit costs me 95.00. My insurance will pick up the blood work. If my insurance refused the labs i would find a way to pay for it. We spend thousands on hair removal, surgeries, wardrobe, it would make more sense to spend some of those funds on your health if need be. Reminds me of when I was racing dirt cars. Drivers would spend thousands to pick up tenths of a second, but refuse to spend 1 dime more than the minimum on a helmet and safety gear to protect their lives.

I have no idea where I might fall on the scale, but the reality for me is I am transitioning and plan to go all the way as fast and soon as circumstances and funds allow. If I found comfort where I am now I would own it and not worry about how much or how little respect I got from someone else not in my shoes. Worry about yourself and only yourself. Not others or even where they are on their journey.

[ReineD]

I must say that gender variant is the most lonely place in the world of transgenderism. CDs can look to us as TS, and true TS can look to us as CDs or gender variants. We get no respect.

I disagree with the lack of respect, but I can see why it is difficult for both sides to understand the middle. But, this will change. There is increasing research that points to a much wider biological spectrum than previously understood, and I think that we are headed towards better understanding for everyone along the spectrum.

If you are in the mood for new terminology (or new labels), have a look at this Dutch paper that compares early onset TSs with late onset TSs who got there via fetish beginnings (as teenagers), but who each deserve medical attention for transition. The idea is that it doesn't matter how the feminine gender identity got there. What matters is, there is a feminine gender identity and the importance is simply to make sure that it is a solid one, before undertaking transition:

http://www.gendersanctuary.com/pdf/xdress/crossgenderidentity.pdf

[LeaP]

I don't think the folks in the TG middle are going to be terribly happy being described as "marginal transvestites"!

This article was interesting to me mostly because it illustrates SO well how hard it is for cisgendered people to understand the condition. Wrapping it in academic language doesn't hide the head scratching much.

The approach was essentially an attempt to reconcile the work of a prior era to better data. That it includes the discredited work of people like Money and Blanchard doesn't help.

There is nothing in the article that hasn't been discussed in a hundred different ways right here.

The pattern of cisgendered academics inventing conceptual frameworks of pathology to describe us continues. What's needed is trans academics who can describe the condition from an internal point of view.

[Erica Lauren James]

Wow Where to start this time? I guess the first thing I'll say is thanks to those of you who have stayed on topic. But I must say I have learned a lot about all the different levels of TS But we must remember ladies that we all only fit in our own heels! And each one of us is different and are entitled to be different.

As for myself I don't think I'll ever just stay in the middle. With just over 3 months of HRT I had a very noticeable difference in breast size and am pretty sure I'd develop to at least a large b or c and I wouldn't want to have that size and still be a male to the world.

So albeit I may not be ready right now I do see it in my future. As I'm just not very productive as a male as I spend way more time having/being Erica time and that is usually at home. So if I was just Erica all the time (in the future) I'm sure I'd be much more productive.

So when I make these statemnets I'm just looking for your opionions on if this is generally a normal thing that most (not all as we are all different) go through?

Thanks

[TeresaL]

Hi Erica. Only you can decide if you need hormones.

For me though, my crossdressing was slapping me around in an addiction-like boxing match, and I was getting beat. I could NOT stop it or slow it down. My first week of hormones greatly diminished it. That was a major miracle in my life. Now my crossgender life is like having a glass of fine wine after a long week. Before, it was like heroine. It choked the life out of me.

Hormones did not eradicate my internal, preferred female gender. It is still there and somewhat less accessible. I have to drill down deeper for her - but she is there! Those are special and pleasant moments to me.

You have to find your comfort zone. I hope you the best.

[Memzy]

That first shot I received was like drinking a cup of pure happy. I swear I was able to puke rainbows for a week.
Since then, I have had my ups and downs, but I am in a much much MUCH happier state now. Like others have said, I try to stay on the positive side of things, and look forward to moving forward into my life.

The first month I did have serious doubts about myself, mainly about the whole "Passing" ordeal, but after a while I suppose I just stopped caring about it as much. Though for a while was having the thoughts of "I'd rather be dead" moments due to GD. It's just something that we need to trek through, otherwise the growth will never happen!

A roller-coaster ride of emotions is normal.

[Marleena]

@Erica Your original post threw some people off. Your negative reaction to hormones sometimes means they aren't right for you, meaning you may not be TS. The majority of TS women only start transition if it's necessary and rarely stop HRT. Only when you explained the reasons why you stopped taking the hormones did it become clear that you decided to delay transition.

[Trisha65]

Transitioning has its share of ups and downs. For me, I have been on HRT for five days. Have I noticed any changes? I am on a "high" as I am so excited that this stage has begun but I do know that I will still have ups and downs, but I try to focus on the ups. For me it seems to make the road shorter when I don't dwell on negatives. Any other changes? I think the my moods are more even and happy go lucky. No physical changes yet with the possible exception of one case of "excited" nipples.