HRT effectiveness ?

[KymberlyOct]

I mentioned this in another thread but it was somewhat off topic so I thought I would try a new thread. I am scheduled to meet with the MD at the transgender clinic where I am a patient in early August. My concern is due to pre-existing health issues that I may not be prescribed hormones or possibly something less than would be standard.

I met for an FFS consultation with Zukowski in early May. He said much of my work is soft tissue and that I should get to my goal weight before FFS. He continued by saying that estrogen will slow down my weight loss. (OK makes sense so far ) He continued by saying that hormones don't have that much of an impact anyway so maybe I should skip them altogether. He has been doing this 20+ years and while HRT is not his area I don't want to simply discount what he said based on his many years of experience.

Any thoughts from those of you on HRT? How much physical effective do you feel that HRT has provided you in a variety of areas. Skin, body hair, fat redistribution, softening of facial features etc. I know it of course differs from person to person but I thought some feedback from a group that has been on HRT would be helpful to hear before I meet with the doc at the clinic in August. My therapist is great but this part is not her expertise.

THANKS for any replies !!

[PretzelGirl]

That is so far off, it is puzzling. You could look at before and after pictures of all of us here and see that it certainly isn't true. Softer skin, breasts, hair, body odor changes, body hair diminishes, muscle mass decrease, fat redistribution on body and face.....

Here is my example. The pic on the left is the day I started HRT, then 1 year later, then 2 years later. And remember, this is just physical changes. The mental changes are the key.

http://www.crossdressers.com/forums/attachment.php?attachmentid=263039&stc=1

[Eryn]

I agree with Sue. HRT was huge for me, both mentally and physically. A FFS surgeon might have tunnel-vision about the subject.

[KymberlyOct]

Thanks Sue and Eryn, anybody else please keep the replies coming. The replies won't make my entire decision or my argument if need be with the docs but it will be a major factor in my thought process.

Sue those pics are amazing regarding how much of a difference. You look wonderful !! Thanks for taking the time to upload them to give me an idea. Pictures say a lot for themselves.
Thanks !!
Kym

- - - Updated - - -

Oops, almost forgot, I agree with you Eryn regarding the tunnel vision of an FFS surgeon. I was thinking that as I listened to him saying it. Again I don't want to discount what he says, he is a doc with a lot of experience but I think his opinions may be shaded somewhat because of what he does.

[Melissa Rose]

My experience was rapid and significant breast growth and slight hip growth via fat deposition being most prominent during the first year. I experienced more skin softening and body hair lightening, loss of upper body muscle mass, areola and nipple growth and emotional/mental changes during the second year. The changes slowed in the third year with the most noticeable being softening of my facial features. The changes seemed to have plateaued going into my fourth year. So HRT did have a significant and noticeable impact in my case.

[Kris Avery]

Yes, HRT was very good to me too.
I do injections for mine and have been hitting the sauce good for almost 19 months now.
Between that and all the laser and electro I do look quite a bit different.
It gets fairly awkward when people see me for the first time in a while.
I'm not social, more of a hermit. I don't really live in the view of the public.
That's probably a good thing too.



The rest of the effects have been a blessing.

[natasha]

For me, anyway, the mental changes far out weigh any physical changes that may have occurred.

[tgirlamc]

Hi Kymberly!... I hope all is well... I am post GRS/FFS and 2.5+ years on hormones... I actually lost 20-25 lbs on hormones due to the loss of my upper body muscle... I had been in the mid 160s and run between 139 and 142 now.... They actually wanted me to gain 10 lbs for fat grafting in my second facial procedure and I could only manage about 5.... Most of that weight was lost by the end of the first year.... I had been considering breast aug but on the advice of a friend waited and am glad I did. I had a growth spurt post GRS and am happy with what I ended up with!!!... I also have noticed some good distribution to the hips/butt that kicked in around the 2 year mark. Skin softening began soon after starting HT...Note: I take my hormones by injection which I had heard gives better results as far as breast growth but I don't know for sure if that is true... But it works for me!!!😀... Anyway... I had 23 hours worth of facial surgery in 2015 (two 11.5hr procedures) so if I can answer any questions about what you might expect just let me know!!!

Take Care!!!
Ashley 😀

[I Am Paula]

HRT is well proven therapy. Even if it is not for body changes, it can do wonders for our mental health. I would have a REALLY hard time trusting a Dr. who is not a specialist in HRT making claims/recommendations like that.

[tgirlamc]

Hi Kymberly! Let me add to what I said earlier... Yes I agree with Paula... I addressed the physical only and failed to include the changes in mood/feelings/thoughts etc... For me those changes were quite profound... Although new to me the changes were quite comforting/comfortable although also a bit of a roller coaster as well with mood swings... I find that I love it all... The low periods as well as the high... It's all part of the ride and I came to recognize that when some depression moves in out of the blue for no real reason, it will pass soon as quickly as it came.... Testosterone is like living somewhere where there isn't much change between the seasons... Estrogen is seeing it all!!! Beautiful Springs and Summers, Spectacular Autumns and a few cold Winters to make you appreciate all the rest....

Take Care,
Ashley 😀

[whowhatwhen]

I think I posted my timeline in SH but if not you can PM and I'll send a link along.

That being said HRT did wonders for me but I think a lot of it was having my hair grown out, losing weight, and having most of the dark facial hair removed.
Also there's the benefit of making boob jokes with total impunity.

[MissDanielle]

It takes 2-3 years for all the physical changes to end so I would avoid any kind of FFS for that reason. aside from fixing up my brows, my face should translate quite well.

[arbon]

Facial hair , Adam's apple, and voice will have the most impact on how you look.

Hrt soften my skin and some features. I never got to a full A cup. Muscle loss. I think the greatest benifit of hrt for me was psychological.

If you had ffs without hrt would you also be having grs or orchiectomy at same. I think you would still want to turn off testosterone

[Mirya]

I had a feminizing rhinoplasty with Dr. Zukowski back in January. One month later, I started HRT for the first time. I know that's totally backwards compared to most people, but I knew that HRT would do nothing to change the structure of my nose (which was huge, wide, and had a big bump on the nasal bridge). I'm extremely pleased with the result that Dr. Zukowski gave me.

If most of the work that you need done is soft tissue work, then maybe you should do HRT first. I know that in just the 5 short months I've been on HRT, my face has feminized quite a lot (not including the rhinoplasty). Especially in my cheeks.

Also, it's possible to lose weight during HRT. It's certainly harder, but with strict diet and exercise, it's possible. For example, I've lost 5 pounds since starting HRT and am now down to 125 lbs on a 5' 7" frame. Just through good old-fashioned diet and exercise.

[KymberlyOct]

THANKS !!! What a bunch of great replies and information. Each a little bit different but a common thread. I think so highly of this group. I know that transitioning is something that takes patience but my window is kind of short due to health issues. I need to get things done while I still am healthy enough to do it. My cardiologist, internist and urologist that is treating my bladder cancer (stage 1 for 4 years go figure) are all in on this. But I am kind of rushing so thanks everyone for the great input.

Arbon - Yes I have been thinking about the orchiectomy the last few days because of the possible HRT issues. This hopefully will get sorted out in the next few months. My first appointment with the MD at the U of MN transgender clinic is in August. That is to discuss the possibility of HRT. She will undoubtedly talk with my other docs and look at my medical records. Oh and Arbon - I remember reading in some other post you thought you still look like a guy ??? You look great !!!!

To not get too long winded here is my tentative plan. Any more input is very welcome. ( 8 hour electrolysis this thursday lol I know that is nothing in the scheme of things)
Anyway here's the plan - see how it goes:
HRT by Sept 1st
FFS by March 1st
BA by June 1st
GRS ??? 2018 ???
If I can't get full HRT maybe spiro at least ???
I know this is NOT the standard order. Normally do HRT a couple of years see where the breast growth is and then BA but my situation is a little different.

If I can at least get the FFS and BA done but they won't let me go through GRS then definitely want to do Orchie - yikes. Does anyone know if that requires the same approvals / letters etc as GRS? I guess the clinic will know but don't see the doc until Aug and my next appt with my therapist is several weeks off.

Thanks again, I hope I can pay this forward someday to future members.
Kym

[arbon]

Does anyone know if that requires the same approvals / letters etc as GRS?

It would depend on the doctor. Some have been able to without the letters others have needed them. When I had mine they said I needed one letter but then when I got there they never asked for it - wasted money.

[whowhatwhen]

I'm gonna pose this to the girls here who've had FFS but isn't 6 months too premature after starting HRT to really consider it?
For me it was at least a year before I even started being read as female, maybe 1.5 before reaching ~90% of the time.

[KymberlyOct]

Thanks for volunteering that you had the orchiectomy. I am hoping for GRS/GCS/SRS whatever it is called these days. My therapist said she is worn out and just calls it downstairs. Anyway, although I want GRS I am mentally preparing myself for stopping at orchie if need be. Thanks for the info.

- - - Updated - - -


I'm gonna pose this to the girls here who've had FFS but isn't 6 months too premature after starting HRT to really consider it?
For me it was at least a year before I even started being read as female, maybe 1.5 before reaching ~90% of the time.

Thanks, seriously. I want tough questions, just be nice about it - as this one was. I know my timeline is not in the norm. I won't keep repeating why. But feedback, even tough questions is good. I am trying to sort this out and act on it in a shorter time than is normal. Would love feedback to whowhatwhen's question.

[arbon]

I don't know why there would be a problem having ffs done early in hrt or even without.

[Mirya]

Thanks, seriously. I want tough questions, just be nice about it - as this one was. I know my timeline is not in the norm. I won't keep repeating why. But feedback, even tough questions is good. I am trying to sort this out and act on it in a shorter time than is normal. Would love feedback to whowhatwhen's question.

As I wrote in an earlier post, I had some FFS done BEFORE I started HRT. Now, 6 months after my rhinoplasty and 5 months after starting HRT, I'm planning on going back for a brow bossing and trachea shave. Dr. Zukowski recommended I get more things done, so I'll think about it, but for now that's my plan.

While it's more common to do HRT for a year or so, then do FFS all at once, I'm proof that you can do things in whatever order you like (as long as your own individual body and mind can handle it). If I had gone the more traditional route and done HRT for a year before any FFS, I would have been either forced to continue living as a man, or continued to look like a man while living as a woman. My nose job made THAT much of a difference.

However, I do plan on waiting significantly longer (at least a year) before considering breast augmentation and SRS (both of which I would like to do). I'd like to wait and see what the HRT does for my breast growth, and I need more real-life time spent as a woman before I'm eligible for SRS. But for FFS, when it comes to bone and cartilage work, I don't see much of a reason to wait.

Here's a cropped photo of me that was taken just 2 days ago. I think I look feminine enoough already, after just 5 months on HRT and a rhinoplasty. I certainly get read as female by strangers all the time, that's for sure. I'm 39 yrs old, btw.
263173

[Badtranny]

It takes 2-3 years for all the physical changes to end so I would avoid any kind of FFS for that reason.

Disclaimer: This is BS.

I realize that it's quite common around here, but making up your own facts is definitely not a cute look. You of course are welcome to avoid FFS for whatever reason and for as long as you like, but nonsense like this doesn't help people who don't know any better.

[whowhatwhen]

2-3 Years may be excessive but I've definitely heard it suggested to wait at least a bit of time for some HRT changes to take effect.
Whether that's misinformation or not doesn't mean it's cool to suggest she's making it up.

[KymberlyOct]

So happy I found this group. I mentioned to someone offline - I may be new to transitioning but I am not new to life. I am pretty good at sniffing out the B.S. Fortunately while I do occasionally see some on this forum it is not much. The vast majority of you provide great opinions and insight. And since I am new to transitioning my B.S. radar may malfunction from time to time so thanks to those of you that point it out when I may miss it.

I will get these issues sorted out over the next few months. The first one will be in August when it is decided what HRT if any my heart condition can handle. Any and all comments are welcome. I will separate the wheat from the chaff.
Thanks
Kym
PS. I almost hit reply and realized Bad Tranny has a point - Maybe I think I am so smart that I can sniff out the BS but it is not just about me. There are usually several hundred people reading each of these posts. And even if I am as smart as I want to think I am - other people reading may get led astray so making made up or incorrect comments is a bigger deal than I originally realized. Look at that I am growing as a person LOL

- - - Updated - - -

whowhatwhen also a good point - misinformation isn't always intentional. Think I will step aside and read the wisdom of others for awhile.

[Mirya]

My advice is to just do what is most comfortable and reasonable for yourself, within your own personal budget and time constraints. After all, that's why we transition, right? To be comfortable in our own skin?

Everyone's body is different. Some people start out looking fairly feminine already, and some people need a lot more work done, whether that's through FFS or HRT or both. Everyone is at a different age too, which also affects HRT effectiveness in changing the physical body. And even within the same age, different people are impacted by HRT at different rates. And everybody's budget is different, which can limit or expand the number of medical things that can be done. I could go on and on...

You know yourself better than anyone. Listen carefully to everyone's experiences, not just here, but in person at local transgender support groups, on other message boards, and anyone else that will offer advice (and believe me, people love to talk about themselves, so all you really have to do is ask and listen! :) Then, make your own judgment on when you want to take each step. There are no steadfast rules in transitioning, and therefore no rules about when you should or should not do certain surgical procedures. But also be aware that if you deviate from the norm, you may expose yourself to additional potential risks. They are considered the norm for a reason, after all.

Gather as much information as you can, then make your own decision based on what you've heard from as many people as you can, factoring in your own unique life experience. If anyone says you "have" to do things a certain way, they're either misinformed or have an agenda of their own IMO.

[Zooey]

Disclaimer: This is BS.

2 years is the number the surgeon I saw for a consult recommended, at least for any kind of soft-tissue work. When it comes to bone, it doesn't really matter when you do it, other than to say that more time on HRT might change how badly you feel you need it.

It's the same as any soft tissue work, like breast augmentations. It is always better to wait until growth/changes have largely stopped before performing work. You can damage developing structures, or alternatively future growth/shifting may affect the appearance of your procedures in undesirable ways.

[Eryn]

It takes 2-3 years for all the physical changes to end so I would avoid any kind of FFS for that reason. aside from fixing up my brows, my face should translate quite well.

Disclaimer: This is BS.

I realize that it's quite common around here, but making up your own facts is definitely not a cute look. You of course are welcome to avoid FFS for whatever reason and for as long as you like, but nonsense like this doesn't help people who don't know any better.

Exactly what part of her statement is "BS"? It seems pretty accurate to me, mirroring advice I've received from medical professionals and my own experience. I've kept detailed measurements ever since starting HRT and the curves are reaching an inflection point about 15 months in. That indicates about 2-3 years to see full effects.

[Donnagirl]

Can I answer this way...

No HRT and after about one year HRT

[Suzanne F]

I decided not to wait. I had Breast Augmentation and SRS 13 months after beginning HRT. I am 51 and I didn't want to wait. My surgeon did not think further breast growth would be an issue. I also adamantly did not want to have to recuperate from 2 surgeries when I could just face them at one time. So yes there are different approaches based on doctors advice and our personal preferences. HRT was the best decision I ever made!

[Barbara Dugan]

I have just close to 7 months and the changes have been subtle but so far I am very pleased with the results so far,HRT has level my physical and emotional needs, I feel very balanced .
I did asked my doctor about timelines and he recomend to wait on breast augmentation, FFS he said it can be done earlier.

[MissDanielle]

Disclaimer: This is BS.

I realize that it's quite common around here, but making up your own facts is definitely not a cute look. You of course are welcome to avoid FFS for whatever reason and for as long as you like, but nonsense like this doesn't help people who don't know any better.

Maybe it was breast growth that I was thinking of. But things like cheek implants might not even be necessary depending on how the fat moves around on HRT.

That said, some of us have faces that translate better going into HRT than others do and won't really need FFS. I know that I'll either have to wear a wig or pray for some sort of miracle for hair regrowth.

[LeaP]

It's a truism that mileage varies with HRT. Too, all of us have some degree of trouble evaluating our own looks realistically. Still, in my case, given sufficient family resemblance and family history knowledge, plus some education on sexually dimorphic facial structure and differences (hard and soft tissue), I arrived at a pretty fair assessment of my limits after about a year on HRT. Skin softening and some rounding over of my features made me look younger and brought my looks closer to those of my sister. I'm fortunate in not having a strong jaw line or prominent chin. But my brow, forehead, and temples, even though none are exaggerated, are clearly male. I could probably get by without rhinoplasty or a lip lift, but would be better for them. Anything more would be cosmetic gravy. It didn't take years to arrive at the conclusion, either. I have had one consult with an FFS surgeon. He came up with the same list, unsolicited, although he also suggested a lower lift.

All in all, I don't know if the suggestion to wait for several years is BS so much as it is a matter of rapidly diminishing returns in terms of information informing your surgery choices … at least if you spend some time studying the topic (and your face).

[Badtranny]

Exactly what part of her statement is "BS"? It seems pretty accurate to me, mirroring advice I've received from medical professionals and my own experience. I've kept detailed measurements ever since starting HRT and the curves are reaching an inflection point about 15 months in. That indicates about 2-3 years to see full effects.

"It takes 2-3 years for all physical changes to end" is patently BS.

How somebody could come into a forum like this and flatly make a statement like that is beyond me. My old Doctor, (Dr Charles Moser) told me changes stop after 18 months. He would know, but my experience is that changes haven't stopped yet after over 6 years. So which is it? 18 months or 6 years?

My changes slowed down considerably before I got the Orchi, then they ramped back up again. So should her advice be amended to include that?

A closeted person who just recently started HRT should maybe, just maybe refrain from advising other people on when they should be getting FFS.

It would appear that many people don't seem to care, about where their advice comes from, but I prefer mine to be from those who walk it rather than talk it.

[MissDanielle]

I just re-looked at the informational packet I got when I went to the endo--the 2-3 years was for breast growth.

[PaulaQ]

The effectiveness of HRT for facial and other physical changes depends on a bunch of factors. Your body's estrogen receptors, the bone structure of your face, the form of estradiol used (different forms work better for different people), your dosage, all sorts of things. I would guess that an FFS surgeon probably doesn't see many who got awesome results from HRT, so that might affect their perception of it.

Here's two old photos of me, 21 months apart. The left, pre everything. The right, 17 months in on HRT. As for effectiveness of HRT, you be the judge. (I need to update this - I'm almost at 3 years.) Even at 3 years, I still see changes, but they've slowed.

263246

[Eryn]

The speed of results vary widely, but I think that most of us who are on HRT can agree that it does affect how our faces look, and this certainly should be a consideration when timing FFS. The original poster stated that her FFS surgeon suggested that she might skip hormones altogether. One probably doesn't want to wait 5-6 years, but a couple of years might be considered prudent. It's even possible that an individual might hit the HRT jackpot and decide that FFS isn't needed at all.

KymberlyOct, take what you've learned here and make an informed decision. One opinion from someone who has a vested interest in getting you onto his table should be balanced against the opinions expressed here that HRT has a valuable function and that it is prudent to wait a while to see what it can do for you. The only disagreement is about the timeframe and that is something that has to be determined individually.

[LeaP]

"It takes 2-3 years for all physical changes to end" is patently BS.

It would appear that many people don't seem to care, about where their advice comes from, but I prefer mine to be from those who walk it rather than talk it.

I understand you now. I took your comment in a FFS readiness context only.

I'll be on HRT 4 years on August 2. I can't speak to the effects of an orchie, but agree that changes over time continue nonethless. In my case, physical development has either stopped or slowed to imperceptible. But some not so nice changes have kicked in. I've finally reached the point, for example, where weight loss is excruciatingly difficult ... something that was still a non-problem 2-3 years in. Along with my siblings (male and female alike), I already had a tendency to put fat onto my thighs and hips - disproportionately so. But the curse that was briefly a blessing is turning into the family curse again.

But I stand by my comments on assessing facial change. My wife says my face has filled in - but I've gained back some of the weight I lost, you know? I don't see any substantive change that matters.

[tgirlamc]

Hey All...

I think our minds can have interesting ways of perceiving change...I noticed an interesting effect with all the changes my face has gone through during the past 2.5 years, from both HT and two different 11.5 hour surgeries... For me, my mind seems to accept the changes as the norm....to the point where my mind is telling me that I have always looked like this and the surgery did very little. Only when I look at pictures of how I looked along the way do I fully realize how big a change has been made and my old face looks foreign to me...If others minds adapt like that as well, then the more subtle changes of HT might sometimes be hard to gauge!

Take Care,
Ashley :-D

[PretzelGirl]

I find it curious that those of us with 2 years or less of HRT are saying you get full effects at 2-3 years. In order to say that, you would need 4 years of HRT to speak from experience. Otherwise, we get into the "My doctor said" which always is a lot of differing opinions.