HRT and Starting Age

[Dorit]

There has been quite a bit of discussion on this and other forums, particularly the TG forum, about the changes that can or not come from starting HRT. I hope this is the best place to post.

I had a conversation with a doctor the other day where I expressed my surprise, and delight I might add, at the profound body changes I have experienced on HRT for the last eight months. I told her that at my age, 70, I had no expectations and thought that at best it would be years before I saw any results. I expressed the commonly help belief the HRT is effective for young people.

Her response amazed me in that she said with her medical understanding it would be especially the older MTF HRT newbies that would experience the most significant changes, not the younger ones! The doctor's explanation was that those, particularly in their 60's and 70's already had a greatly reduce level of testosterone, plus their body's ability to "fight" the T-Blocker was also greatly reduced. The problem with HRT is not adding estrogen, but reducing the powerful hormone testosterone and its overriding effects on estrogen. The young ones in their 20's and 30's had high T levels to begin with and a strong endocrine system that would fight the T blockers!

So this is a very interesting view, and certainly confirms someone like me. So one question is, because there seems to be quite a few older women here, are there others in their "senior" years that have just begun HRT and have experienced profound changes?

The other point is that the studies of disappointing breast growth after one year on HRT are probably loaded with young participants. Are not the vast majority of transgenders beginning HRT today in the 20's and 30's? How many 60 or 70 year olds start HRT? So these studies might be largely irrelevant to the more mature population on this forum! Ladies, there might be a real advantage to our age!:heehee:

[Richelle]

I hope your doctor is correct. I started at 64 and been on HRT now for 5 months.

[LeaP]

A lot of people have started HRT later in life. I started at 58 with good results. My starting T levels were very high - close to 1000 ng/dL. They didn’t come down easily, either.

[Devi SM]

I was middle 58 and I idn't have huge expectations for the same, the age it at 8 weeks I was scared of the breast grow, so the chest around, today I measure it again and is 1 inches. My breast is very noticeable but I doubt it will grow more.
My mother in law the hasnt seen me in a year, when she me doing video conference ask me what's my secret that i look so young. In my face just eyebrows and a lot of people says the same, I guess is the hormones.

[AllieSF]

I hope that your doctor is correct. There will be a lot of late starters out with unexpected good results.

[Heidi Stevens]

Hi Dori. I started HRT 40 months ago, right after my 59th birthday. About two months in, I had my first levels test. The E was up to 47 and my T was down at 86. My doctor said I must have been low T before the spironolactone. Normal male T is 250 to 1000.

I just had a follow up test and E is 150 and T is 2. That’s right, TWO! I was quite happy with that. The doctor said I could increase my E dosage if I wanted, but I am happy where I am now.

Over the past 3+ years, I have had some base breast growth, but I would barely fill an A cup. My upper thighs are slightly bigger as well. Keep in mind that I ramped up to my current levels of E over 18 months. I’ve only been at current dosage for 22 months and the E level has held around 150. Remember that this is post menopausal level.

Bottom line is the older starters have the advantage of lower T at start and apparently benefit more from Spiro.

[Chrissi]

Hi Dori, it seems today is my answer HRT questions...lol

I started at 54, and I am coming up to a full year.
My T level was borderline low for a male at my first blood test the day I started (without looking it up I think it was 304). At my last test it was 6. My E is was 97. After my first 3 month checkup, my Endo doubled my E dose and kept my T blocker the same. I have been on that dose since.

As for physical changes. I have actually recorded them. I have lost muscle mass in my shoulders (-1"), & chest (-.5"), have gained in my bust (+1"), have lost in my band (-0.75") , have lost several inches on my waist (-3"), and gained in my hips (+1.5"). Luckily I was always nearly hairless, and what little I did get, is pretty much non existent now, or really that fine vellus type hair now. I no longer need to shave my forearms, my toes or my knuckles. I responded very well to laser, and while I still need to "shave" it is a couple of swipes with a razor that lasts several weeks (the razor, that is).

[Contessa]

There might be a couple disadvantages also. I recently was told that I had a stroke. I am pretty much okay except for some use in the peripheral vision in my right eye. I can still see though out of both eyes. But wasd told by a doctor in the hospital to stop taking estradiol. I must inform you as I did my endocrinologist "I can't. I left the endo's office thinking I would continue taking the same dose. But have since lowered it my self. I'm 66 and am still this through. I'm not ready to die yet. But I can't go back to being that other person. I have been on HRT for 5 years. Should I believe ESTRADIOL caused this or just the pill. I should switch to the patch or injection? Or is it age?

[Jeri Ann]

The other point is that the studies of disappointing breast growth after one year on HRT are probably loaded with young participants. Are not the vast majority of transgenders beginning HRT today in the 20's and 30's? How many 60 or 70 year olds start HRT? So these studies might be largely irrelevant to the more mature population on this forum! Ladies, there might be a real advantage to our age!:heehee:

I normally do not post in this section that is visible to any and everyone but I fit the criteria and have been on HRT much longer than most who have responded. My journey has matured way past the early stages of hopes and dreams that evolved out of, and were perpetuated by hearsay and myths. It seems that the proverbial "Real Life Experience" requires being a realist. I do, however, remain a sanguine realist.

This is a quote from from a medical journal "Endocrine Today",

“The effectiveness of hormones … tend to be less satisfactory as patients become older and have gone through a long number of years with their own endogenous hormones,” Cavanaugh said. “So, absolutely the effectiveness is determined by the age of the patient, and also by genetics.”

About surgeries Dr. Cavanaugh said this, “Many younger people can’t afford them,” Cavanaugh said. “Most of the patients, at least in my experience and in this country, undergoing gender-affirming surgeries tend to be older and generally really do quite well. Surgeons are very careful about trying to optimize patients’ health status — getting them to quit smoking, making sure their hormone levels are well managed. So, even though there is a greater concern with older patients, I would say most of the surgery we see done — even when patients are in their 60s — really tend to do well.”

I know of no study that reports that most transwomen who start HRT are younger. There was a study I read that attributed more positive results in younger trans people to higher levels of HGH. I will try to find that study again.

It seems common to experience rapid results in the first 12 - 18 months of HRT. It alarms some and pleases some. After the initial spurt of growth it seems to end there. This is only my perception based on my reading, research and experience in the transgender community. BTW, the thirty or so transwomen, that I have met in the last year here in the Houston area, have never heard of this forum. I have asked. Also, not one of them grew voluptuous breast with HRT. A couple have big breast but they are very "large" girls who had a lot of adipose tissue to begin with.

Many transwomen accept the results they get from HRT, they resign to being a small breasted woman. There are several reasons for this and is a personal decision. Some, however, desire a more proportional body and opt for breast augmentation.

Typical MTF breast growth reportedly results in tubular breast. These are real breast that have somewhat pleasing projection and may be at home in a bra but they do not occupy a great deal of real estate on a male chest. Tubular breast will even respond to gravity and have a profile that resembles natural female breasts. A nicely endowed female physique, however, typically has breasts that come close at the sternum and extend out to, or just past, the side of the chest. They also extend up toward the shoulders. Wouldn't it be wonderful to achieve this by using patches, pills or needles?

During an insane quest for maximum growth I injected and took pills. I absolutely do not recommend trying this. It didn't matter to me I was borderline suicidal anyway. Fortunately I survived. Unfortunately it didn't make any difference. The ultimate results I got were, at last, just typical. I had resigned myself to being fairly small breasted. I didn't need, and couldn't use, forms. With just a push-up bra I had eye catching cleavage. As it turned out, my situation changed and I opted for augmentation.

For me, breast augmentation was the best thing that could have ever happen to me. With 38 DD breasts I was way past the point of no return. There was no turning, or even looking back. Like Cortes, I had burned my ships. It was Jeri Ann facing the world with confidence.

Please understand that this is only my experience and my perception. I do not intend to discourage anyone. But, false hope leads to disappointment. Many of you have contacted me by pm, email, texts and or phone call. For you that know me, you know that I am a realist. I believe it is important to be realistic. But, as has been said many times here, "Your mileage may vary." Maybe someone will get lucky and grow their own set of "knockers." It would be cool to see. Good luck to everyone.

[Dorit]

I am not a doctor, but I do believe that for now it is almost impossible to pinpoint "The Cause" of such health issues as a stroke. What we can do is to manage the risk factors that we have some control over, such as diet, exercise, mental attitude, etc. There are also risk factors that we have no say in, like genetic inheritance and age. The literature I have read says that Estradiol does not in and of itself cause clots, but is associated with a small increase in risk for clots and stroke. So you and your doctor should look at your overall risk picture for strokes and decide if stopping Estradiol would make a significant reduction in risk for another stroke. Maybe losing weight would be more effect, or stopping smoking? I am not saying you have these risks, just using them as an example. Whatever you decide, I can certainly sympathize with your desire not to go back! I wish you the best.

[Carlene]

I too am about the same age as Dorit. I have been taking hormones for two years and have experienced profound results both physically and emotionally. Hair growth is greatly reduced, skin is much softer, breasts are noticeable and always tender, T levels are below 1, while E levels are comparable to a pre menopausal woman. The most significant changes I have experienced though, have been regarding self esteem and emotional connection to others.

Carlene

[LeaP]

I’m not so sure about the doctor’s explanation. First, estradiol is a much more powerful hormone than testosterone. Second, circulating blood serum levels don’t tell the whole T story. Males make - and consume (metabolize) - huge amounts of testosterone - nearly 100 times that of a female.

[Dorit]

"First, estradiol is a much more powerful hormone than testosterone."



Of course a phrase like "more powerful" is a vague term. I was relating to the fact that for MTF HRT to work, it is essential that there be a testosterone blocker. For FTM HRT to work, it seem that most just add testosterone. While there is a drug that is considered an estradiol blocker, it seems that the addition of testosterone takes care of the estradiol, unless there is a particularly high level of estradiol to suppress.

I was also relating to my own personal experience. My pre-HRT blood test revealed an unusually high level of estradiol in my blood. As a matter of fact, the endocrinologist accused me of taking estrogen on my own before I came to them. I was not. I was prescribed a testosterone blocker and estradiol, first pills, then later patches. My testosterone fell off the chart, my estradiol rose a bit. I experience profound body changes that began in the first months and continue today. So it was my experience that blocking my testosterone released the natural estrogen in me to take over! Of course this is not really scientific, it is just anecdotal.

[Laura912]

“Of course this is not really scientific, it is just anecdotal.”

And therein is the difficulty of discussing hormonal effects in this forum.

[Rianna Humble]

On the contrary. Anecdotal evidence is all that we can offer.

Even those members who have medical qualifications cannot offer a truly professional opinion as they have not had the opportunity of a face-to-face consultation with the other poster(s).

Dorit's experiences are valid and serve as a good example of members' personal experience.

The vast majority of threads discussing HRT in this forum point out that we are only sharing personal experience and are not saying that the same effects will be experienced by the enquiring members.

[LeaP]

I may have used an imprecise term, but it is nonetheless considerably, directionally correct. You may not like like generalities, but the potency of testosterone is approximately 1/100,000 that of 17b estradiol.

Hormone potency at the cellular level is (and has been measured) as a combined function of receptor affinity - specifically binding strength - and efficacy in the response or gene transcription sense (not the vague pharmaceutical marketing sense) for endogenous and exogenous hormones. In addition, potency itself is influenced by dosage. Specific tissues can be considered in potency considerations. And relative ratios are hugely important to receptor regulation.

Estradiol in non-trivial dosages IS anti-androgenic. Take enough E and you won’t need separate anti-androgens. The current practice of prescribing both in MTF regimens is to balance effect against risk, as high estrogen dosages are risky. Nonetheless, your statement re needing anti-androgens for MTF HRT to work is just plan wrong. It is BETTER to take down androgen levels, certainly, but not strictly necessary. Feminization effects due to elevated E levels alone, no matter how initiated, are well-known. Feminization effects from taking anti-androgens alone are due to endogenous estrogens, not the lack of testosterone. (Ratios again.)

FTM regimens raise yet other considerations. While it is true that most regimens “just” add testosterone, to say it takes care of the estradiol is misleading. Simply adding T will trigger body/facial hair changes, for example, but it turns out that in the female body most of the masculinization is caused by ... wait for it ... estradiol produced by the aromatization of the excess testosterone!

Re estrogens and mood: MANY pharmaceutical effects related to mood are known, including estrogenic effects on acetylcholine, serotonin, dopamine, and norepinephrine. The problem is reducing (or attributing) the known general affective influence of these on emotion and cognition to mood specifically. To term the (rather obvious, IMO) relationship a myth is to dismiss the forest for lack of a tree species. It’s not unreasonable in this case to posit the existence of the specific species.

I agree, clinical tools are not mentioned enough. I’m fortunate to be a clear Tanner stage 4 in terms of breast development. I’ve also measured volume in the past, but don’t have the numbers handy. Those are helpful in a quantitative sense, and usually good enough for the purposes commonly used in medicine and clothing for cis women, but aren’t descriptive enough for most trans women. It would be helpful to have some MTF-specific feminization metrics for the body, even if only expressed in change terms rather than target terms.

[Dorit]

Lea, thank you for your very thorough reply! I stand corrected on the science, I am not in your league!: You obviously have an background in endocrinology, while I only gain my knowledge from extensive reading of articles posted on the net, some of which are of course scientific research. I will keep my mouth shut on this type of issue.:heehee:

I would hope that this forum is an open place for us who to love to express our personal experiences and thoughts, alongside those who love to quote professional studies and articles with a scientific approach. There is room for both, I do not believe there has to be an "either or" approach or a sense of whose approach is more valid, please let it not be a place of competition.:eek:

[LeaP]

I don’t have a background in endocrinology. Rather, I’m a (limited) armchair expert by necessity, as I wanted to understand what HRT would do to me physically ... and then rapidly discovered the *enormous* complexity in the topic as well as the lack of knowledge and research applicable to cross-sex hormone administration and manipulation. I’m in my 7th year of HRT and starting reading in endocrinology well before I started.

Believe me, I know my limits. I do not have a medical background, biology background, or chemistry background. I know little to nothing of endocrinology outside of sex steroid-related topics and directly-related systems and biofeedback mechanisms, and even there with a decided emphasis on cross-sex application “knowledge,” such as it is. But I do know enough there to be a source for the physicians I’ve used so far for my own medical care and HRT.

I’ve been told by more than one physician (non-endocrinologists) that I know more on the topic than they do. Think about that for a minute. Scary! But that’s that’s why I say that within the trans population itself is the best repository of knowledge on the topic of cross-sex hormones. (Unfortunately, it’s also the population with the most MISinformation ...) Tough position to be in, but you ultimately should be prepared to be an active participant when it comes to your own healthcare and start taking HRT.

Please do not stop talking about HRT! I agree with you on the value of personal experience and thought. I agree that there is no single approach to HRT (far from it, in fact). And believe me, I get my share of corrections and new information.

[Lana Mae]

I am 67 and about to approach my GP for his support! Then to the Endo! The info here and the research on the net has helped immensely with my decision! I am not going into this with a whole lot of expectations for dramatic changes and will take it as it comes! Yes, I would love some C cup breasts but I am not expecting them! As I said the info/experiences of the girls here and the info on the web were invaluable! This is the next step on my journey and I will be moving forward slowly! Hugs Lana Mae

[Katya@]

I
Estradiol in non-trivial dosages IS anti-androgenic. Take enough E and you won’t need separate anti-androgens. The current practice of prescribing both in MTF regimens is to balance effect against risk, as high estrogen dosages are risky. Nonetheless, your statement re needing anti-androgens for MTF HRT to work is just plan wrong. It is BETTER to take down androgen levels, certainly, but not strictly necessary. Feminization effects due to elevated E levels alone, no matter how initiated, are well-known. Feminization effects from taking anti-androgens alone are due to endogenous estrogens, not the lack of testosterone. (Ratios again.)


Lea - thank you for your post. The research I made on the quoted topic before embarking on HRT journey pointed to the same. As a non-binary person, and based on consultation with my endocrinologist, I decided to not directly suppress production of Testosterone with spironolactone. I do however take dutasteride to block conversion of testosterone into dihydrotestosterone to stop any balding. At initial small dose of E (0.050mg via patch), my T dropped from 464NG/dL to 327NG/dL, and at the next dosage of 0.075mg, it dropped all the way down to 75NG/dL. The Estradiol level went up from 20 pg/mL to 50 to 96 pg/mL respectively. I experienced breast growth, skin softening, and mood improvement and thus I shared my experienced in several posts in NB section and Trans Body Issues. I felt it was one path that I could not find any anecdotal evidence on this forum. The only thing I am disappointed about is the lack of effect on body hair. I feel my legs are just as hairy and thickness of hair on the chest is just as big. So I am doing electrolysis on my chest hair and still don't know what to do about hair on my legs. Shaving is not working for me.

[LeaP]

My experience with body hair is that it didn’t reduce to its full extent for nearly 5 years. Body hair has a longer lifecycle than most facial hair ... it just takes longer to go away.

[MarieTS]

I'd like to briefly take this in the opposite direction to get everyone's thoughts. I recall during the 6th grade desiring to transition. I was prepubescent. If I had the support structure at that phase of my life, I have to believe the physical transition would have been quicker and perhaps more complete because at that point there were no physically masculizing traits to reverse.

My question being, is anyone aware of initiatives to begin mtf mones for ts youth? The med community needs to face reality and make the lives of those youth who were blessed with understanding parents easier before the rampaging effect of androgens sets in.

[Jeri Ann]

Marie,

Here is a video link on that subject. I spoke to the Board of Education on this little girl's behalf a few months ago.

https://l.facebook.com/l.php?u=https%3A%2F%2Fyoutu.be%2FQD720mHFqW0&h=AT3PHkMmTQQtlxTeL1KTGtAtXMzdr-ZbDHJfl4G3eZiWz3rB93beNhXw9dPao6wbL4KShoyqmGHZb_Ba 1PEZCozQ34ozTF7LQybUgxUg2oXvgdYmV3aYzh7whlzKaorc7o JsKEMihLrZEPM-vZqYjD7tr1IJLHwepwcm6HUA90UfI4B_Z4SsXWVanc8oeWFT1W ah6MkNJjJTQWCjsRo-DAYfq486PlG1JI6lU_oAnt7fqj8I598mgWmYufABAdeqOfuscR t_ilowG1zt2dUbi1CW0QAjrpnfVJd__65NInXfoCdm5-7rs6r531XPbLGGGnTRqLtIfEmZPU_jhSxfeu0Pzra6p-m4MK_vBx4spjnRJv3J6bMR6bqZVtIThcVxE7uQ3pS7DIN3ZHzn PEI18y91L2CRUWP4D6S1P89MBXyiOigd5w

[MarieTS]

Thank you, Jeri Ann. I began IDing as early as the toddler stage and by grade 4 had strong thoughts something was off. I dreamed of moving away and starting over as who I knew myself to be. I am glad that is possible now. Your support for the little one in the video speaks volumes!

[Aprilrain]

the studies of disappointing breast growth after one year on HRT are probably loaded with young participants. Are not the vast majority of transgenders beginning HRT today in the 20's and 30's? How many 60 or 70 year olds start HRT?

In my experience, there are many people your age on HRT. Just look around here at the number of middle aged or older transitoners. Yes there are many more young people coming out and being themselves these days but its not like we just invented trans people. Older folks are benefiting from the vast increase in this new found worldwide understanding of how common we are, thank you internet.

That being said when it comes to HRT and gender confirming surgeries, statistics are necessary and useful for us as a demographic but completely irrelevant to you as an individual. You will know what you are going to "end up" looking like when your dead! Six years on hormones and my body is still changing. The most profound changes have occurred since having GRS. I wasn't willing to wait for hormones roulette wheel so I got implants early. I've never regretted it and my boobs continue to change as does the rest of me physically and mentally. I have been surprised at how much of an impacted surgery has had on the effectiveness of the hormones. Numbers wise, I actually have a little bit of T now where as when I was on blockers there was none. Paradoxically I have feminized more in the last year than the previous six in terms of over all physique. I have quite literally gone through a metamorphosis that quite frankly, I wouldn't recommend, but it worked for me!

- - - Updated - - -

They have puberty blockers that stave off the effects of endogenous hormones in adolescents. I do know of under 18 girls on estrogen but where they get it, I don't know.

[MarieTS]

April, you have had a bit of a roller coaster hormonal ride, but it sounds as if your body has finally figured it out. I am glad for you.

As for the under 18 crowd, they are no doubt highly managed by the med community. Oh how I wish that resource of puberty blockers, estradiol, and and adoloescent pre op counselling had been available for me. Better late than never, and I am happy that today's younger generation has these resources.

[Contessa]

Hi all
I should have returned sooner to talk about myself since my stroke. Well I have seen my endocrinologist since the last time i was here. She has told me to stay on my original doses of HRT. I am on a few extra medicines now. So I'm good or better. No longer as stressed as at first. Thank all of for your posts about my condition hope I was able to shed some light and help another member.

[elizabethamy]

Hi everyone,

I'm north of 60 and just 3 months into HRT; Spiro & Estradol in pill form. I keep reading here and there that the pill version of estradiol is ineffective and even possibly counter-productive in that it gets converted into estrone which is apparently not something we want a lot of. Like everyone I'm eager for big changes to happen and know that it's going to take a lot of time but should I ask my doctor to consider patches, shots, or other delivery systems? Does this matter?

Too many humanities courses and no medical training.

elizabethamy

[Laura912]

Elizabethamy, first, make sure your doctor has extensive experience with hormone therapy in MTF patients. Next, make sure your estrogen and testosterone levels are being monitored because they are the key for guiding effective therapy in most people.. Lastly, make sure the treatment is individualized to your needs which may, in fact, require different delivery methods.

But you knew all that, right?

[elizabethamy]

Laura,

I did know all that, though I suspect my dr (a GP) is maybe a little super cautious about this. Won't get my first level check until October so then I'll know if we have made any progress at all...thanks.

[Dorit]

Laura's advice about being sure your doctor has extensive experience with transgender HRT is important. It is difficult for me to believe that a GP in Indiana has such experience, but of course it is possible. Do you have access to an endocrinologist, it would probably be best. From my own experience, I too was started on oral Estradiol. Blood work was done after two months and was then changed to Estradiol transdermal patches. Things really took off after that!:eek:

[LeaP]

The primary site for cross-conversion between estradiol and estrone is the liver (it goes both ways), as controlled by a gene on chromosome 17. Taking oral estrogens introduces them via the hepatic portal directly into the liver. You can take most estradiol pills sublingually instead of swallowing them, which puts the majority of the estradiol directly into circulation.

[Aprilrain]

April, you have had a bit of a roller coaster hormonal ride,

You have no idea :eek:
If by finally figured it out you mean 3 shots of estrogen ago then, yeah, maybe.
Took pills for 5 years, then a GP switched me to patches. They weren't working.
In addition to the constant hot flashes :bonk: I started breaking out in an itchy red rash from the adhesive,
the residue of which wouldn't come off until the skin it was attached to came off.
So onward and well... this is one of those moments were I'm pretty sure the universe is like, so you want be a girl eh?
would you stick a gigantic needle with a huge syringe FULL of estrogen into your own ass for it missy?
to which I say
Yes ma'am may I please have another!

WHACK!

[April T]

Thanks for sharing. I'm 55 and wondering

[Jeri Ann]

this is one of those moments were I'm pretty sure the universe is like, so you want be a girl eh?
would you stick a gigantic needle with a huge syringe FULL of estrogen into your own ass for it missy?

Injectable Estradiol Valerate requires only a 22 gauge, 1 1/2" needle and a very small quantity of solution, hardly a syringe full. The needle does need to be inserted all the way but it is not a horrible experience. I injected weekly for three years. Doctor switched me back to pills.

[LeaP]

I passed out cold - again - at my last blood draw in August. I woke up with 2 nurses propping me up and the phlebotomist waving a capsule under my nose. Then off to an exam room, via a wheelchair, for 15-20 minutes to be monitored before they let me escape. (They got the blood, thank GOD.)

The idea of sticking myself gives me the willies. I’ll stick with the pills ...

[elizabethamy]

Either the E or the Spiro are giving me intestinal fits. As a person who hates and avoids all things medical, I find myself totally willing to try patches, pellets, or even self-administered injections if it will keep the hormones going and alleviate the gut troubles. I see the dr. next week though she does know about my troubles. Here's a fun twist: the insurance company now won't pay for them to test my E and T levels prior to the Dr. appointment, only after. So I guess my Dr. and I are supposed to talk about the weather, then get the results of the test? How does that help anybody? Arggh.

At least the HRT appears to be working, at its deliberate pace...thanks for advice. (And I may live in Indiana, but in this town I am surrounded by frighteningly smart people, including my GP. Endo availability is problematic as it's a drive and several months wait for an appt with a trans-friendly one...so I'll stick with my GP until it clearly just isn't working, right now it seems to be, though rockily)

[Sarah Doepner]

I turned 69 a few months ago and just started HT a month and a half ago. While it may change later, I'm taking both E and T orally for now as I determine how I'm responding to the slow but noticeable changes to my mind and body. I'm most pleased with the major reduction in the daily angst I'd been feeling for the last several years and at times I'm actually feeling what may be "happy" for the first time in a very long time. It took me years to sort out all the various issues that I've faced and after dealing with everything else, this was the only thing left to try. I probably could have started a few years ago, but I wanted to be sure that this was the best choice for me and those I care about. It turns out they are glad I'm doing this because I'm much nicer to be around now. While I'm not all that fond of the pain associated with breast tissue growth, it's a small price to pay for the relief I'm feeling between my ears.

My doctor is the go-to in our region for this kind of therapy and she told me I was nowhere near the oldest person she has been treating and spoke of one MTF starting at age 84 and doing well. I have two close friends who are both a year or two older than me and although they may have started before me and farther along in their transitions, they are doing well physically and mentally. Age seems to be less of an issue than attitude in this group.