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]

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 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