I recently reached the 2-year anniversary of starting Hormone Replacement Therapy (HRT), so I’m taking a moment to see how my life has changed in these two years.
What was it like to start HRT?
When I started HRT, I still believed that I was Genderfluid, and my dysphoria was all-consuming. I approached HRT cautiously, not wanting to go too far in a wrong direction. I depended on my endocrinologist to give me the correct information and select the correct dosages, and requested that we try to keep them as low as possible while reducing the dysphoria.
Once I started taking the medicines, though, my emotional state became more stable and the dysphoria diminished slightly. By the end of the first month, I knew it was the right answer. I pushed for increasing doses (and was frustrated when my endocrinologist seemed to be taking it too slowly) and began learning about how hormones work in the body and what the typical ranges for the various hormones are in males and females.
As the months went on, I was able to increase my dosages, and correspondingly my emotional state improved even more and the dysphoria went from a vague whole-body sensation to come into focus around specific areas and body parts. It was this new focus, along with unpacking and reprocessing early childhood memories, which showed me the truth – that I’m not genderfluid, but I am a transgender woman. Since realizing and accepting that, my life makes much more sense to me – both past memories and current feelings and thoughts. While I can’t say that I wouldn’t have discovered that truth without hormones, it certainly would have taken longer and would have been accompanied with significantly more suffering. HRT helped me immensely in showing me my path.
What has HRT changed for me?
HRT has given me much greater access to my emotions. Before HRT, I had two emotions – anger and (what I identified as) happiness. But most of my existence was stuck in an emotional desert – I really didn’t feel anything at all. After figuring out I had gender issues, I added sadness, depression, anxiety and despair to my emotional menu. I could cry, but it hurt really badly – as though I’d tried to swallow a grapefruit whole and it got caught in my throat, it wouldn’t go down, and I couldn’t cough it up, either. HRT enabled me to cry effectively and without that physical pain; yes, whatever I was crying about was painful, but the act of crying was actually useful and ultimately helped me to feel better sooner. HRT also opened up my menu to include more nuanced emotions: excitement, euphoria, contentment, sorrow, and I discovered that happiness could be so much more than I’d ever experienced before! I developed a much more sensitive ability to feel empathy – something that had mystified me earlier in life; back then, I knew I should feel something about someone else’s emotions, but I had a hard time actually feeling it.
The texture of anger changed for me as well. Before, anger was a physical stress which built up within me – my muscles tensed up and began to beg for some kind of physical release. Now, anger is just as hot and searing, but I don’t have the physical tension, nor the need for release. I can feel the sources of my anger – sadness, indignation, jealousy, loss, feeling cheated, etc. – which gives me a better ability to address the source and defuse the anger, instead of not knowing and having it build until it explodes.
My body has changed with HRT. My skin has become softer, I’ve lost a lot of body hair (good riddance!), I’ve lost muscle tone, and my body doesn’t smell the same as it used to (thank goodness!). My face has changed shape in (to me) imperceptible ways, probably partly due to a little fat redistribution. My hips have become slightly bigger (fat redistribution), and I’ve developed breasts.
All of this has combined into substantial mental benefits. When I look in the mirror, I can see myself – the woman who has been hidden inside of me is finally looking back in the mirror (wow! that still feels amazing each time!). I am connecting with my body – when before I felt a complete inability to dance, now a good beat will get me moving… not quite dancing, but it feels so good! My thoughts have uncluttered; before HRT, I had mental filters in place to detect and suppress any thoughts or emotions I considered “feminine”, and that took a lot of mental energy. Now my thoughts flow freely, unencumbered by that filter.
I frequently have a thought which, when it occurs to me, makes me feel butterflies in my tummy or gives me a warm and satisfied sensation: “I’m a woman! I get to be a woman!” That idea still feels unreal sometimes, but HRT has given me the ability to see it, feel it, and finally, believe it!
I plan to continue HRT indefinitely. One way I look at hormones is like fuel in an engine – if you put gasoline in a diesel engine, it might run and might even get you down the road, but it won’t be smooth; when you put diesel fuel in the engine, it runs much more smoothly and efficiently. I was able to run on testosterone, but it wasn’t the right fuel for me. Estrogen has proven to be the right fuel, and I see no benefit to ever using a different fuel.
I’ve transitioned legally (see What’s in a name?), and have been living full-time for past two years, and these have been good steps.
While the dysphoria has improved, it has also informed me where my next steps could be. About a year ago I reached out to a surgeon to begin the process of qualifying for and scheduling vaginoplasty (bottom surgery). I’ll get into the details in future posts, but right now, I have surgery scheduled for 2019.
Another area of increasing importance to me is my voice – I feel that while it isn’t overly deep, it still marks me as masculine. This could be due to inflection, word choice, phrasing, and a variety of other factors which we use to guess at another person’s gender through their voice. I am still consistently identified as a man in voice-only situations (phone calls and fast-food drive-thrus, for example).
While there are many other potential steps I might take in the future, beyond bottom surgery and possible voice training, these remain more nebulous and lower priority. While I keep track of these possibilities, I’m not actively pursuing any of them. I have enough going on as it is.
So that’s it. Things are going pretty well in my transition so far, and I have a few things coming which promise to change my world. Transition is doing what I need it to do – I am feeling more at peace with myself than I ever have before, and I get great comfort in knowing that I’m on the right path.
Until next time,